It is year 2009.
A 16 year old boy presented with Anginal pain.
I think this child underwent successful surgical correction.
What is the mechanism of angina in coronary AV fistula ?
Coronary steal is easy explanation. But, very few of them develop functional Ischemia even at exertion. Why ? Size of fistula. dainage site, complex tortuous tracts, associated microvascular obstruction, contribute more.
Reference
Angelini P. Functionally significant versus intriguingly different coronary artery anatomy: anatomo-clinical correlations in coronary anomalies. G Ital Cardiol. 1999;29(6):607–615. [PubMed] [Google Scholar]
Dr.S.Venkatesan MD 